NPI | 1326230491 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A45216) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A45216) |
207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A45216) | |
207V00000X Obstetrics & Gynecology (Licence: CA A45216) | |
208D00000X General Practice (Licence: CA A45216) | |
Enumeration Date | 2007-08-13 |
Last Update Date | 2007-08-13 |